RBC transfusion requirements after allogeneic marrow transplantation: impact of the before‐transplant Hb level on transfusion and early survival
Bibliographic record
Abstract
BACKGROUND: Most patients undergoing allogeneic marrow transplantation (alloBMT) require transfusions of RBCs. A retrospective analysis was performed to evaluate the utilization and risk factors for RBC transfusions including age and sex of recipient, HLA matching between donor and recipient, disease status at time of BMT, the occurrence of GVHD, ABO blood group compatibility, the source of progenitor cells and the Hb level before BMT (PT-Hb). STUDY DESIGN AND METHODS: Data from 519 consecutive patients receiving transplants between January 1995 and March 2000 were reviewed. The number of RBC transfusions was determined for the following periods: 0 to 60, 61 to 120, and 121 to 180 days after BMT. RESULTS: The transfusion requirements were greatest during the first 60 days after BMT and decreased with time. The total number of units transfused to this cohort of patients was 5398, of which 3505 units were utilized within the first 2 months. The mean number +/- SD of units transfused per patient from 0 to 60 days was 6.8 +/- 6.4; 61 to 120 days, 3.2 +/- 5.5; and 121 to 180 days, 2.0 +/- 4.6. An increased transfusion requirement was associated with lower PT-Hb, major ABO mismatch between donor and recipient, BMT in patients with more advanced disease, use of unrelated donors, older age, and female sex by Spearman's correlation analysis. The source of progenitor cells and the development of GVHD did not influence transfusion requirements. Increased mortality during the 6-month period after transplant was associated with lower PT-Hb, use of unrelated donors, advanced disease status at BMT, and sex by Cox regression analysis. In a multivariate model, PT-Hb remained significant when controlling for the other risk factors. CONCLUSION: The PT-Hb was identified as an independent risk factor for RBC transfusions during alloBMT. As well, a lower PT-Hb was found to be an independent risk factor for increased mortality during the 6-month study period.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".